Incidence and Risk Factors of Chronic Postoperative Pain in Same-day Surgery: A Prospective Cohort Study
Author:
Boko Melodie Fanay1, Khanna Ashish K.2, D’Aragon Frederick3, Spence Jessica4, Conen David5, Patel Ameen6, Ayad Sabry7, Wijeysundera Duminda N.8, Choinière Manon9, Sessler Daniel I.10, Carrier Francois Martin11, Harlock John12, Koopman Josèph S. H. A.13, Durand Madeleine14, Bhojani Naeem15, Turan Alparslan16, Pagé Gabrielle17, Devereaux P. J.18, Duceppe Emmanuelle19ORCID, , Daila Carling Roberta, Lapointe Catherine, Baptiste Diane, Chergui Imène, Deligne Elliott, Jannat Sheherazade, Hamtiaux Myriam, Lalonde Juliette, Hare Jacqueline, Lawrence Kelly, Gregus-Juriansz Emily, Gregus Krysten, Lombardo Kristen, Trombetta Lisa, Abdulrahman Muammar, Tidy Antonella, Baranov Adriana, Clarke Anne, Selvanayagam Sathurthika, Tissot-Therrien Maxime, Bouchard Marie-Pier, Belisle Julie, Carbonneau Élaine, Pellerin Dominique, Casavant Ève-Marie, Côté Line, d’Hervé Ilyona, Grégoire Justine, Lamontagne Félix, Ladha Karim S., Pazmino-Canizares Janneth, Lota Maya, Mattina Gabriella, Drozdz Sandra, Mokonnen Tedros, Nayar Roshni, Thomas Zaaria, Douglas Jaffe Jonathan, Eaton Amelia, Harris Lynnette, Youshock Evan, Autade Sheetal, Bell Carter, Bouldin Bethany, Coffield Alexandra, Deschler Emily, Disher Nataya, Eberting Jaclyn, Eller Seth, Faircloth Spencer, Holbrook Justin, Keleghan Aidan, Kyong Kim Tae, Lydic Tanner, Mathis Lakyn, McCabe Raleigh, Motamedi Vida, Rahmah Tiye, Reeves Jessica, Reynolds Abigail, Sahajpal Rishika, Samant Anusha, Schellenberg Michael, Sura Tanmay, Sykes Lily, Tahir Rabeya, Tingey Spencer, Tore Mert, Treadway Robert, Ward Sydney, Hofstra Richard L., Araujo-Duran Jorge, Marquez-Roa Leonardo, Diz Ferre Jose L., Insler Joshua E., Kopac Orkun, Abbas Aram, Corrales-Martinez Maria J, Dussan Catalina, Ekrami Elyad, Cipriani Annie, Slife Maeve, Rodriguez Fabio, Mosqueda Michael, Gatt Richard, Reimelink Conny, Koopman Ankie
Affiliation:
1. 1Department of Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada. 2. 2Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Outcomes Research Consortium, Cleveland, Ohio; Perioperative Outcomes and Informatics Collaborative, Winston-Salem, North Carolina. 3. 3Department of Anesthesiology, University of Sherbrooke, Sherbrooke, Quebec, Canada. 4. 4Department of Anesthesia and Critical Care, McMaster University, Hamilton, Ontario, Canada. 5. 5Department of Medecine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada. 6. 6Department of Medecine, McMaster University, Hamilton, Ontario, Canada. 7. 7Outcomes Research, Anesthesiology Institute, Cleveland Clinic–Fairview Hospital, Cleveland, Ohio. 8. 8Department of Anesthesia, Unity Health Toronto–St. Michael’s Hospital and University of Toronto, Toronto, Ontario, Canada. 9. 9University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Department of Anesthesiology and Pain Medicine, University of Montreal, Montreal, Quebec, Canada. 10. 10Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio. 11. 11University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Department of Anesthesiology and Pain Medicine, University of Montreal, Montreal, Quebec, Canada. 12. 12Department of Surgery, McMaster University, Hamilton, Ontario, Canada. 13. 13Department of Anesthesiology, Maasstad Hospital, Rotterdam, The Netherlands. 14. 14Department of Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada. 15. 15Department of Surgery, University of Montreal, Montreal, Quebec, Canada. 16. 16Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio. 17. 17University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Department of Anesthesiology and Pain Medicine, University of Montreal, Montreal, Quebec, Canada. 18. 18Department of Medecine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada. 19. 19Department of Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Population Health Research Institute, Hamilton, Ontario, Canada.
Abstract
Background
The amount of same-day surgery has increased markedly worldwide in recent decades, but there remains limited evidence on chronic postsurgical pain in this setting.
Methods
This study assessed pain 90 days after ambulatory surgery in an international, multicenter prospective cohort study of patients at least 45 yr old with comorbidities or at least 65 yr old. Pain was assessed using the Brief Pain Inventory. Chronic postsurgical pain was defined as a change of more than 1 point in self-rated average pain at the surgical site between baseline and 90 days, and moderate to severe chronic postsurgical pain was defined as a score greater than 4 in self-rated average pain at the surgical site at 90 days. Risk factors for chronic postsurgical pain were identified using multivariable logistic regression.
Results
Between November 2021 and January 2023, a total of 2,054 participants were included, and chronic postsurgical pain occurred in 12% of participants, of whom 93.1% had new chronic pain at the surgical site (i.e., participants without pain before surgery). Moderate to severe chronic postsurgical pain occurred in 9% of overall participants. Factors associated with chronic postsurgical pain were active smoking (odds ratio, 1.82; 95% CI, 1.20 to 2.76), orthopedic surgery (odds ratio, 4.7; 95% CI, 2.24 to 9.7), plastic surgery (odds ratio, 4.3; 95% CI, 1.97 to 9.2), breast surgery (odds ratio, 2.74; 95% CI, 1.29 to 5.8), vascular surgery (odds ratio, 2.71; 95% CI, 1.09 to 6.7), and ethnicity (i.e., for Hispanic/Latino ethnicity, odds ratio, 3.41; 95% CI, 1.68 to 6.9 and for First Nations/native persons, odds ratio, 4.0; 95% CI, 1.05 to 15.4).
Conclusions
Persistent postsurgical pain after same-day surgery is common, is usually moderate to severe in nature, and occurs mostly in patients without chronic pain before surgery.
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
Publisher
Ovid Technologies (Wolters Kluwer Health)
Cited by
1 articles.
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